Compliance with hand hygiene is inversely associated
with a high workload, like that found in the PACU.11,13 The impact of hand hygiene on HAIs in 20 hospitals between 1977 and 2008 was significant. Improved hand hygiene practices reduced infection and cross-transmission rates. One hospital-wide hand hygiene campaign resulted in an improved level of hand hygiene compliance for 8 years. The campaign interventions included the introduction of dispensers of alcohol-based hand rub on the wall, at the bedside, and in the pockets
of health care workers, coupled with hand hygiene
observations, training, performance feedback, and
posters. The campaign resulted in a sustained increase
in hand hygiene compliance from 48% to 66%, a 48% decrease in HAIs, and an 87% decrease in cross-transmission of MRSA. Research has linked duration of patient care to the amount of bacterial contamination. Anesthesia providers were found to have a hand bacterial count of 3.2160.66 (log10) at the induction of anesthesia
that decreased to 2.5561.15 (log10) during maintenance,
to 2.6761.10 (log10) during extubation, and to 3.5760.74 (log10) at the end of anesthesia administration. Anesthesia providers were observed to have only a 62% hand hygiene compliance rate after moving patients into the PACU and before leaving the PACU. Direct patient contact, respiratory tract care, and handling of body fluid secretions caused the highest rates of hand contamination. Patients who have a prolonged stay in the PACU have a greater risk of contamination, most likely for the same reasons